Pancreaticoduodenectomy for Pancreatic Cancer, Short- and Long-Term Outcomes After Kausch-Whipple and Pylorus-Preserving Resection

Pancreatic cancer (PDAC) is a common cause of cancer death and is difficult to treat because of late presentation, disease heterogeneity, and treatment resistance. Long-term overall survival remains poor, with a 5-year survival rate of 5%, and unchanged over the last three decades. For PDAC in the head of pancreas, pancreaticoduodenectomy with curative intent is the only treatment modality that offers a chance of cure. With the development of effective neoadjuvant chemotherapy and significantly reduced surgery-related mortality, more patients with PDAC will have a chance of pancreaticoduodenectomy. There is currently no effective prognostic tool to identify subgroups of PDAC patients for stratification of treatment and prediction of survival. Beside the classical clinical–pathologic factors, in the future it will be necessary to integrate genetics data into a prognostic model and look for new types of preoperative biologic survival factors. In this chapter, we will discuss the short- and long-term outcome after pancreaticoduodenectomy for pancreatic cancer and their associating factors.